[Cardiovascular complications in minor endogenous hypertriglyceridemia. Study of 235 cases]

Compared with other hyperlipoproteinaemias, minor hypertriglyceridaemia of type IV in Fredrickson's classification (serum concentrations below 5 g/l) has been the object of few studies. From a study of 235 patients presenting with this metabolic abnormality, 64 were isolated who developed vascular lesions. Our patients' recruitment system makes it impossible for us to provide figures concerning the frequency of vascular lesions, but it enables us to present two important qualitative assessments. Firstly, a different profile seems to differentiate patients with atheromatous lesions from those with accidents of arterial thrombosis. The latter are heavier, consume significantly greater amounts of tobacco and alcohol and are significantly younger when vascular complications occur. Metabolically, they have a lower blood cholesterol/triglycerides ratio and a lower serum concentration of apolipoprotein B. In those who develop myocardial infarction compared with those who suffer from angina the cholesterol/triglyceride ratios are 1.38 and 0.91 respectively, and the serum levels of apolipoprotein B are 1.57 g/l and 1.20 g/l respectively (normal value: 1.30 g/l). Secondly, the very high frequency in our population of inaugural myocardial infarction is an original clinical finding. It provides and additional argument in support of the theory that hypertriglyceridaemia may be a contributing factor of arterial thrombosis. This study emphasizes the point that metabolically as well as clinically pure hypertriglyceridaemia is a very heterogeneous metabolic abnormality, as shown by its repercussions on the vascular system.